Cigarettes, social reinforcement, and culture: a commentary on "Tobacco as a social currency: cigarette gifting and sharing in China".

As Rich and Xiao suggested, cigarette sharing and gifting play an important role in China's smoking epidemic. Understanding the cultural roots, history, and impacts of such practices should be emphasized in tobacco control efforts. "Tobacco as a social currency" is a consequence of the tobacco industry usurping traditional values and cultural customs to make cigarette gifting acceptable, desirable, and socially reinforcing. The cigarettes-social reinforcement link created by the tobacco industry can be broken by deglamorizing smoking and cigarette gifting and by reinforcing alternative healthful behaviors. A behavioral ecological perspective, with an emphasis of understanding and engineering cultures, should guide future health promotion efforts to reduce smoking and other risk practices in China.